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Komen Race for the Cure

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Volunteer

We Need YOU!

Volunteers play a vital role in the Susan G. Komen SC Mountains to Midlands Race for the Cure®. Their passion and commitment is what makes our Race successful. This disease has touched so many people, either through their own personal experience or that of a loved one. Will you join our passionate fight by volunteering on Race day?

Last year, individuals from all walks of life volunteered their time and talents before, during and after the Race to ensure its success. We need leaders, thinkers, movers and shakers, educators, communicators…all types of talented people. We look forward to having you join in the Race experience with us!

All volunteers must fill out our Volunteer Application. You will receive our volunteer newsletter and be contacted to sign up for specific volunteer opportunities and shifts. If you have any questions at all, please email volunteer@komenscmm.org or call 864-234-5035. Thanks so much for dedicating your time to Komen for the Cure and helping us to fulfill our vision: a world without breast cancer!

Volunteer Application

*1.

Question - Required - Date

Month

Day

Year

Your information:

Name:

First Required	Last Required

Email: Required

Street 1: Required

City/State/ZIP:

City Required	State Required	ZIP Required

Phone Number: Required

Employer: Required

Occupation: Required

Date of Birth:

Yes, I would like to receive e-mail from Susan G. Komen SC Mountains to Midlands Affiliate

Email Format:

Yes, I would like to receive postal mail from Susan G. Komen SC Mountains to Midlands Affiliate

*3.

Question - Required - I prefer to be contacted by:

*4.

Question - Required - Have you ever been convicted of a felony?

*5.

Question - Required - Have you been charged with any crime involving a child?

Question - Not Required - If yes, explain:

Question - Not Required - Do you wish to be recognized as a breast cancer survivor?

Question - Not Required - If you speak a foreign language and are willing to share your skills, please indicate which language(s)

Question - Not Required - Why do you want to volunteer for Komen for the Cure?

10.

Question - Not Required - Have you volunteered for Komen for the Cure in the past?

11.

Question - Not Required - If so, when?

12.

Question - Not Required - Please list any additional skills that you would be willing to contribute

*13.

Question - Required - Please indicate which volunteer opportunities you may be interested in (You may select multiple areas)

	Data Entry
	Event Planning
	Race for the Cure
	Finance
	Fundraising
	Grant Writing
	Health Care Professional
	Journalism
	Photography
	Public Relations
	Public Speaking
	Teaching
	Survivor events
	Public Policy
	Community Health events

14.

Question - Not Required - How often would you like to volunteer? Weekly
Monthly
Occasionally

15.

Question - Not Required - Daytime availability

16.

Question - Not Required - Evening availability

17.

Question - Not Required - Weekend availability

18.

Question - Not Required - I'm interested in a: Leadership position
Support position

19.

Question - Not Required - Please list any specific positions that you are interested in applying for below.

Komen Volunteer Release
Emergency Contact:

20.

Question - Not Required - Name:

21.

Question - Not Required - Phone:

22.

Question - Not Required - Relationship to Volunteer:

I wish to volunteer for Susan G. Komen for the Cure, SC Mountains to Midlands Affiliate. I understand that the nature of volunteer activities that I may perform in my capacity as a volunteer may involve physical activity, contact with unidentified or unfamiliar persons, or other potential risk of bodily injury or damage to property. Knowing this, I hereby assume full and complete responsibility for any personal injury and/or property damage that I may sustain or cause during my participation as a volunteer. In addition, I hereby release, hold harmless & covenant not to file suit against the Komen Affiliate, Susan G. Komen for the Cure, Inc. and of their employees, volunteers, partners, agents, Sponsors, Board Members and Successors from any and all loss, liability or claims I may have arising out of my service as a volunteer. I understand that as a volunteer, I may become privy to confidential information about the Komen Affiliate or Susan G. Komen for the Cure. I agree to maintain the confidentiality of any information marked “confidential” as well as any information about the Komen Affiliate’s or Susan G. Komen for the Cure’s internal procedures, business operations, personnel information and the like that is not otherwise publicly disclosed by the Komen Affiliate or Susan G. Komen for the Cure. I will not use any confidential information in any manner that would be detrimental to the Komen Affiliate or Susan G. Komen for the Cure, and I will avoid any actions that might impair the reputation of the Komen Affiliate or Susan G. Komen for the Cure.

*23.

Question - Required - Volunteer Signature:

24.

Question - Not Required - What is your T-shirt size?

SC Mountains to Midlands Affiliate of Susan G. Komen©
531 South Main Street, Suite ML-10, Greenville, SC 29601 · Phone: 864-234-5035 · Fax: 864-234-5036 · Email: info@komenscmm.org

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